| Eagan Valley Dental Center | |
|
14050 Pilot Knob Rd Apple Valley MN 55124-6647 | |
| (952) 423-4414 | |
| Not Available |
| Full Name | Eagan Valley Dental Center |
|---|---|
| Speciality | Dentist |
| Location | 14050 Pilot Knob Rd, Apple Valley, Minnesota |
| Authorized Official Name and Position | John David Mittelsteadt (PRESIDENT) |
| Authorized Official Contact | 9524234414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Eagan Valley Dental Center 14050 Pilot Knob Rd Apple Valley MN 55124-6647 Ph: (952) 423-4414 | Eagan Valley Dental Center 14050 Pilot Knob Rd Apple Valley MN 55124-6647 Ph: (952) 423-4414 |
| NPI Number | 1073953832 |
|---|---|
| Provider Enumeration Date | 06/26/2013 |
| Last Update Date | 06/26/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073953832 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 9922 (Minnesota) | Primary |
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